So they would cover a bone graft if there is trauma with the patient? What if the patient had comorbidities that required the patient to have heavy prescription usage and led to xerostomia and bone loss in the jaw? Then the surgeon would have to remove the tooth and place a bone graft? The link you posted doesn”t clarify whether a bone graft would be excluded since it is not part of the extraction or the implant. https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage/index Just trying to get clarification on this so any insight would be helpful. Hi Guest! Great question. We have seen this, however it is not something we recommend. There was actually a webinar hosted by Noridian pretty recently that warned against this type of billing, and even showed a few audit cases studies where providers were audited and many cases were found where bone grafts and extractions that were done were paid when they should not have been. They do look for evidence in the records to confirm the services were performed due to radiation services or trauma.
